The effects of certain drug-testing programs on injury reduction in the workplace: an evidence-based review

Published evidence relevant to the effect of introducing a worksite drug-testing program (other than for pre-employment purposes) on injury or accident outcomes was evaluated. Articles from peer-reviewed journals, technical and government reports, and unpublished documents were retrieved using a systematic approach. Papers with data allowing comparison of non-testing versus testing or a change in testing method were evaluated for independent measures of effect of the program. From the 740 abstracts reviewed, 101 papers were selected and read. Six of them addressed the objective to greater or lesser degrees; five provided data on the impact of a new drug-testing program on injuries or accidents and one addressed the effect of random versus non-random testing. All used ecologic databases that did not allow independent analyses for aggregate measure of effect. Shortcomings in study designs and limitations of the data included and/or tests of significance preclude conclusions regarding the effect of drug-testing programs on injury reduction. Despite the extensive use of and management support for worksite-based drug testing, the published evidence for effects such as reduced injury or accident rates lacks scientific detail. Better studies and careful reassessment of this issue appear warranted.